P228 Appendiceal Orifice Inflammation Is Associated with Lower Rate of Complete Endoscopic Remission in Patients with Ulcerative Colitis

Abstract

Background Appendiceal orifice inflammation (AOI) is commonly considered a skip lesion in ulcerative colitis (UC). However, the clinical significance of AOI in UC patients remains controversial. This study aimed to evaluate the clinical feature and long-term outcomes of AOI by comparing UC patients with and without AOI. Methods This study was conducted as a retrospective design of patients who were newly diagnosed or referred within 3 months after diagnosis at Seoul St. Mary’s Hospital from January 1, 2001 to December 31, 2020. All patients underwent index and follow-up colonoscopies. The long-term outcomes involved achieving complete endoscopic remission (ER), use of biologics, hospitalization, and proximal disease extension. Complete ER was defined as Mayo endoscopic subscore 0. Results In total, 318 UC patients were included, of which 140 had AOI. The baseline characteristics were not significantly different between AOI and non-AOI groups. The cumulative risk of complete ER was a significant difference between AOI and non-AOI groups (p=0.041). The other cumulative risks of disease outcomes were not significantly different between AOI and non-AOI groups (use of biologics, p=0.542; hospitalization, p=0.795; proximal disease extension, p=0.403). The multivariate Cox regression analysis also revealed that AOI was the only significant factor of complete ER (hazard ratio, 0.636; 95% confidence interval, 0.446–0.906; p=0.012) in UC patients. Conclusion AOI shows a significant association with lower rate of complete ER in UC patients. Therefore, a meticulous treatment strategy may be recommended to achieve complete ER in UC patients with AOI.

A case of ulcerative colitis complicated by a simple appendiceal opening

“…In a long‐term follow‐up study by Oh and colleagues involving 318 UC patients, 140 of whom had AOI, the AOI group demonstrated a lower rate of endoscopic complete remission compared with the non‐AOI group. However, there were no significant differences between the two groups in terms of other clinical parameters, including the use of biologics, hospitalization rates, and proximal disease extension 5 . Conversely, a retrospective analysis by Kyong and colleagues, involving 376 UC patients with an average follow‐up time of 66.1 months, revealed no significant differences between the AOI and non‐AOI groups in terms of endoscopic remission, hospitalization rates, recurrence rates, or the use of corticosteroids, immunosuppressants, and biologics 6 .…”

“…However, there were no significant differences between the two groups in terms of other clinical parameters, including the use of biologics, hospitalization rates, and proximal disease extension. 5 Conversely, a retrospective analysis by Kyong and colleagues, involving 376 UC patients with an average follow‐up time of 66.1 months, revealed no significant differences between the AOI and non‐AOI groups in terms of endoscopic remission, hospitalization rates, recurrence rates, or the use of corticosteroids, immunosuppressants, and biologics. 6 Therefore, the role of AOI in predicting the prognosis of UC patients remains inconclusive.…”

A Case of Ulcerative Colitis Complicated by a Simple Appendiceal Opening

“…In a long-term follow-up study by Oh and colleagues involving 318 UC patients, 140 of whom had AOI, the AOI group demonstrated a lower rate of endoscopic complete remission compared to the non-AOI group. However, there were no significant differences between the two groups in terms of other clinical parameters, including the use of biologics, hospitalization rates, and proximal disease extension [5]. Conversely, a retrospective analysis by Kyong and colleagues, involving 376 UC patients with an average follow-up time of 66.1 months, revealed no significant differences between the AOI and non-AOI groups in terms of endoscopic remission, hospitalization rates, recurrence rates, or the use of corticosteroids, immunosuppressants, and biologics [6].…”